We introduce you to our newest patient, who is a 57-year-old lady who has a complex medical history. She also suffers from longstanding pains, in many areas. These pains have been going on for years and are very debilitating for her. She has seen your colleague recently who has increased her analgesia - but it’s not working. She is booked in to see you to increase them further. How are your skills in managing chronic pain - are you up for the challenge?

We introduce you to our newest patient, who is a 27-year-old lady who is pregnant and a member of The Church of Jesus Christ of Latter-day Saints. She has already been to see the Midwife, who has directed her towards you for your expert input. She wishes to know more about the antenatal screening programme in the UK. Specifically, she wishes to avoid unnecessary screening and have minimal intervention during her antenatal care. How’s your knowledge of antenatal screening? Are you up to the challenge?

We introduce you to our newest patient, who is a receptionist at your practice. She has been there for around 6 months but now struggles with some of her roles and responsibilities. Your practice manager has given her some amended duties, short-term, to help. She feels however that she can’t return to her previous roles, and that the PM is bullying her into it. She needs your help. Are you able to navigate this ethical minefield?

We introduce you to our newest patient, who is a 7-year-old patient called Timothy. He was seen with his Mum at your GP practice. He had an ear infection, and it was felt to be viral, consequently, no antibiotics were prescribed. Mum later visited an ‘Out of hours’ GP, who reluctantly gave in to Mum’s concerns and prescribed antibiotics. Dad is now furious. “Why are the GPs at the practice so incompetent, when it was obvious that Timothy needed antibiotics!” He has booked an appointment with you to discuss his concerns. Are you up for the challenge?

New case added: In our commitment to expand some of the areas in the curriculum we have fewer cases, we are continuing with “Ethnicity, culture, diversity, inclusivity”.

As such, we introduce you to our newest patient, who is 45 years old and has congenital hemiplegia. He feels that his work is treating him unfairly, and he needs your help. Are you up for the challenge?

New case added: In our commitment to expand some of the areas in the curriculum we have fewer cases, we are continuing with “Ethnicity, culture, diversity, inclusivity”.

As such, we introduce you to our newest patient, who is 18 weeks pregnant. She has just been to see the midwife who is unhappy with her elevated blood pressure readings in clinic. Will you be able to manage her problem, whilst also recognizing and valuing diversity and her culture?

New case added: In our commitment to expand some of the areas in the curriculum we have fewer cases, we are starting with “Ethnicity, culture, diversity, inclusivity”.

As such, we introduce you to Nasir. He has Diabetes and has recently been started on insulin. Ramadan is starting in 10 days time, and he needs your help. Are you up for the challenge?

New case added: welcome to our most challenging case yet. Have you got what it takes to solve Margaret’s issues? She may be presenting with many symptoms, but is there something that ties everything together? This case is a complex one that focuses on managing frailty and polypharmacy within our ageing population.

New case added: Meet Geri, She is a pleasant and active 78 year old lady who is being increasingly plagued with falls. This is getting in the way of her retirement, and she has been advised by the Practice Nurse to book an appointment with yourself. The Nurse has kindly arranged blood tests, and undertaken an examination, which has all come back normal. Are you able to work out what’s going on, and help Geri?

New case added: Can you help a patient who is really struggling with his arm pain? He has a high-powered job, and the pain is getting unbearable. Worst of all, he sometimes feels a tightness in his chest! This morning he broke down in tears, his wife booked this appointment for him. Can you find, and manage the hidden agenda?

New case added: Can you help George, who is an Army Vet from the Iraq war who is known to have PTSD. Life circumstances have gotten on top of him, and he is struggling in many aspects of life. Do you know enough about PTSD management and social support for war veterans to help George?

New case added: Are you ready to help Miss Green, who is a pleasant 44-year-old lady who has been brought in by her Son’s Social Worker? She walks into your consultation with a black eye and a low mood. Are you able to work out exactly what’s going on, and how are you going to help her?

New case added: Are you ready to help Mr Gummings, who is a 41-year-old gentleman who has Motor Neurone Disease? He needs your help with one last request. How will you navigate the ethical dilemmas presented in this case?

Celebrating our 105th case! New case added: this is a more complicated and difficult presenting complaint. If you can get the diagnosis correct - then good on you! This case tests your capacity to manage a case that you may not be able to diagnose. How will you manage uncertainty, are you up for the challenge?

New case added: Kelly has been feeling faint at school, this is the third time it’s happened. Are you able to work out what might be the cause - and how will you handle the resulting professional dilemma?

New case added: John has been diagnosed with metastatic lung cancer, he has deteriorated recently and his wife is uncertain about what to do. She has called the Palliative care nurse who has in turn sent you a task asking you to speak to John’s wife. This is a complex case, with multiple problems to solve - are you up for the challenge?

New case added: Professional Consultation with a Staff Nurse at a care home. The nurse is worried about John’s leg pain, it appears to have come on quite suddenly, and he appears uncomfortable with it. John has advanced dementia and is residing in the local care home. Are you able to help John?

New case and new heading added to our portfolio: Professional Consultations. The RCGP has made it clear that they will be adding in SCA cases where candidates will need to converse with other medical professionals. Here is an example of one such case, where a Paramedic needs your help managing a lady with delerium. Are you up to the challenge?!

New case added: Bleeding whilst on HRT. Can you help your 56-year-old patient who has been recently swapped from sequential to continuous combined HRT. She has ongoing bleeding and has already seen your colleague who hasn’t been able to help. Will you know what to do? Test your HRT knowledge on our newest case.

We are proud to announce our 100th SCA Case! This case is the second in our series on HRT, and focusses on a 48-year-old lady who is already on HRT, but wants to start testosterone replacement therapy. Can you help her?